Abstract
Introduction: Amniotic fluid is the protective fluid surrounding the fetus which provides support for the growing fetus. Amniotic fluid volume abnormalities are associated with a number of abnormal fetomaternal outcomes. Antepartum surveillance with the assessment of amniotic fluid volume has become an integral component in the management of pregnancies at risk to avoid abnormal maternal and fetal outcome.
Objectives: The primary objective of the study was to study the fetomaternal outcome in amniotic fluid abnormalities. The secondary objective was to study the risk factors in abnormal fetomaternal outcome in amniotic fluid abnormalities.
Methodology: A hospital based cross sectional study was carried out among600 antenatal women admitted at SAT Hospital, Trivandrum, diagnosed with amniotic fluid abnormalities. A semi structured questionnaire was used to collect data. The data was analyzed using SPSS v.20 (trial version).
Results: It was observed that 428 women (71.3 %) had abnormal maternal outcome. The abnormal maternal outcomes were categorized into groups. 259 women (43.2%) had cesarean deliveries. 8 women (1.3%) had instrumental deliveries. 228 women (38%) had induction of labor. 74 women (12.3%) had malpresentation. 14 women (2.3%) had post partum hemorrhage. 4 women (0.6%) had placental abruption.
In this study 371 women (61.8%) had abnormal fetal outcome. 197 (32.8%) babies were preterm. 313 babies (52.1%) had low birth weight (< 2.5 kg). 122 babies (20.3%) had low APGAR (<7 at one minute). 229 babies (38.2%) were admitted in NICU. 28 babies (4.7%) had congenital anomalies. 13 babies (2.1%) had neonatal death. 35 babies (5.8%) had been admitted in NICU due to meconium stained amniotic fluid.48 babies (8%) had respiratory distress syndrome
Keywords: Amniotic fluid, Respiratory distress, Feto maternal outcome, Cesarean Delivery.
References
- Phelan JP, Ahn MO, Smith CV, et al. Amniotic fluid index measurements during pregnancy. J Reprod Med 1987; 32:601.
- Shenker L, Anderson C. Intrauterine diagnosis and management of fetal polycystic kidney disease. Obstet Gynecol. 1982 Mar;59(3):385-9.
- Casey BM, McIntire DD, Bloom SL, et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol 2000; 182:909.
- Chauhan SP, Sanderson M, Hendrix NW, et al. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis. Am J Obstet Gynecol 1999; 181:1473.
- Golan A, Wolman I, Sagi J, et al. Persistence of polyhydramnios during pregnancy--its significance and correlation with maternal and fetal complications. Gynecol Obstet Invest 1994; 37:18.
- Seeds AE. Current concepts of amniotic fluid dynamics. Am J Obstet Gynecol 1980; 138: 575-586.
- Alberto BM, Stefania F. Amniotic fluid dynamics. Acto Bio Medica 2004; 75:11-13
- Abramovich DR, Page KP. Pathways of water between liquor amnii and the feto placental unit at term. Eur J Obstet Gynecol 1973; 3:155.
- Lotgering FK, Wallenberg HCS. Mechanisms of production and clearance of amniotic fluid. Semin Perinatal 1986; 10:94.
- Wladimiroff JW, Campbell S. Fetal urine-production rates in normal and complic-ated pregnancy. Lancet 1974; 1:151.
- Pritchard JA. Deglutition by normal and anencephalic fetuses. Obstet Gynecol 1965; 25:289-97
- Scott JS, Wilson LK. Hydramnios as an early sign of esophageal atresia. Lancet 1957; 2:569
- Adamson TM, Brodecky V, Lambert TF. The production and composition of lung liquid in the in-utero fetal lamb: Fetal and neonatal physiology. NewYork: Cambridge University press 1973:208-12.
- Gilbert WM, Moore TR, Brace RA et al. Amniotic fluid dynamics. Fet Med Rev 1991; 3:89-94.
- Kilpatrick SJ, Safford KL, Pomeroy T. Maternal hydaration increases amniotic fluid index. Obstet Gynecol 1991; 78:1098.
- H. Beall J.P.H.M. van den Wijngaard M.J.C. van Gemert M.G. Ross. Regulation of Amniotic Fluid Volume. Placenta Volume 28, Issues 8-9, Pages 824–832, August–September, 2007.
- Brace RA, Wolf EJ. Normal amniotic fluid volume changes throughout pregnancy. Am J Obstet Gynecol 1989; 161:382-388.
- Manning FA, Hill LM, Platt LD. Qualitative amniotic fluid determination by ultrasound: Antepartum detection of intrauterine growth retardation. Am J Obstet Gynecol 1981; 139:254-58
Corresponding Author
Dr Vasanthakumari K P
Associate Professor, Dept of O and G SAT Hospital
Govt. Medical College, Trivandrum